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Operational Woks Application OPW18-0071, DA Form 1, 1 of 2 · OPW18/0071
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Department of Infrastructure, Local Government and Planning PART 9 — FOR OFFICE USE ONLY Date received: [FT Reference number(s): | Notification of engagement of alternative assessment manager Prescribed assessment manager Name of chosen assessment manager Date chosen assessment manager engaged Contact number of chosen assessment manager Relevant licence number(s) of chosen assessment manager QLeave notification and payment Note: For completion by assessment manager if applicable Description of the work ( Leave project number Amount paid ($) Date paid Date receipted form sighted by assessment manager Name of officer who sighted the form The Planning Act 2016, the Planning Regulation 2017 and the DA Rules are administered by the Department of Infrastructure, Local Government and Planning. This form and all other required development application materials should be sent to the assessment manager. Page 11 DA Form 1 — Development Application details Version 1.0—3 July 2017
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